Significance of lymphatic invasion and cancer invasion-related proteins on lymph node metastasis in gastric cancer |
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Authors: | Itaru Kamata Yukio Ishikawa Yuri Akishima-Fukasawa Kinji Ito Yoshikiyo Akasaka Miwa Uzuki Ai Fujimoto Hiroshi Morita Seiichi Tamai Tadaaki Maehara Kentaro Ogata Reiko Shimokawa Yoshinori Igarashi Kazumasa Miki Toshiharu Ishii |
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Institution: | Department of Pathology, Toho University School of Medicine,;Department of Gastroenterology and Hepatology, Omori Medical Center, Toho University,;Pathology Division, National Cancer Center Research Institute, Tokyo,;Departments of Pathology and;Surgery, National Defense Medical College, Tokorozawa,;Department of Pathology, Kyosai Tachikawa Hospital, Tachikawa, and;Department of Pathology, Saiseikai Yokohama City East Hospital, Yokohama, Japan |
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Abstract: | Background and Aims: Cancer invasion and metastasis are critical events for patient prognosis; however, the most important step in the whole process of lymph node (LN) metastasis in gastric cancer remains obscure. In this study, the significance of cancer cell behaviors, such as cell detachment, stromal invasion and lymphatic invasion on regional LN metastasis in gastric cancer was investigated by comprehensive immunohistochemistry. Methods: A total of 210 cases with gastric cancer were selected. These consisted of 105 cases with regional LN metastasis (LN+] group) and 105 cases without LN metastasis (LN–] group). Both groups exhibited the same depth of invasion. Cancer tissues were subjected to immunohistochemistry with antibodies against claudin-3, claudin-4, β-catenin, matrix metalloproteinase (MMP)-1, and MMP-2, as well as endothelial markers of lymphatic vessel endothelial hyaluronan receptor-1 and von Willebrand factor for the objective discrimination between lymphatics and blood vessels. The expression of each protein as well as the histopathological parameters were compared between LN(+) and LN(?) groups. Results: Along with lymphatic invasion by cancer cells and gross tumor size, MMP-1 expression in cancer cells at the invasive front of the primary tumor was a significant, independent predictor of LN metastasis. The expression of claudins and β-catenin was associated with the histopathological type of cancer, but not with LN status. Conclusion: Among the cancer invasion-related proteins examined, MMP-1 plays a vital role in LN metastasis of gastric cancer. Tumor size, lymphatic invasion and MMP-1 expression level at the invasive front were the predictive factors of LN metastasis of gastric cancer. |
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Keywords: | gastric cancer lymph node metastasis lymphatic invasion lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) matrix metalloproteinases (MMP) |
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